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Item The Impact of the Working Alliance on Vocational Outcomes for People with Severe Mental Illness Enrolled in Employment Programs(2007-07) Kukla, Marina Elizabeth; Bond, Gary R., 1944-This study was a subset of a large two-year randomized controlled trial of two employment programs providing services to people with severe mental illness (SMI). Because prior research has found that the strength of the relationship, or working alliance, between service providers and people with SMI is related to a variety of beneficial outcomes, the purpose of the current study was to address the working alliance between participants and their vocational workers and its association with employment outcomes, including the total duration of paid employment over two years and mean paid job tenure after two years. Another primary purpose of the current study was to determine whether working alliance differences exist between a team vocational approach (Diversified Placement Approach) and an individual vocational approach (Individual Placement and Support Model). The final aim of the current study was to investigate the psychometric properties of the ad hoc scale utilized to measure the working alliance. Contrary to expectations, no relationship was found between the working alliance and employment outcomes after two years. As expected, it was found that participants in the individual vocational approach (IPS) had higher working alliance scores across the study than participants in the team vocational program (DPA). Finally, the working alliance measure used in this study was found to have promising psychometric properties, including adequate criterion-related validity and test-retest reliability, although the internal consistency was a bit low. The scale items are a loose fit with existing theory, however, necessitating the addition of items and revision of the current scale and underlying theory to enhance its utility in clinical and research settings.Item Randomised Controlled Trial Evaluating the Strengths Model Case Management in Hong Kong(Sage, 2022-08-24) Tse, Samson; Yu, Chong Ho; Yuen, Winnie Wing-Yan; Ng, Catalina Sau-Man; Lo, Iris Wann-Ka; Fukui, Sadaaki; Goscha, Richard J.; Chan, Sunny H. W.; Wan, Eppie; Wong, Stephen; Chan, Sau-Kam; School of Social WorkObjectives: Strengths-based approaches to case management for people with mental illness have been widely used in Western countries. The aim of this study was to evaluate the effectiveness of Strengths Model Case Management (SMCM) among mental health clients in Hong Kong. Method: Two hundred and nine service clients were recruited from three Integrated Community Centres. Multiple measures related to recovery progress (e.g., Recovery Assessment Scale) were reported by both the clients and caseworkers before intervention and at 6 and12 months post-recruitment. Results and conclusion: Although there were no significant differences in improvement of most outcomes between the SMCM and control groups, the recovery scores of the SMCM group remained stable over time regardless of age, and also middle-aged participants (i.e., 40–59 years old) in the SMCM group achieved higher recovery scores over time than those in the control group. Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN) 12617001435370.Item Veterans’ Pain Management Goals: Changes During the Course of a Peer-led Pain Self-Management Program(Elsevier, 2016-12) Bauer, Sarah M.; McGuire, Alan B.; Kukla, Marina; McGuire, Shannon; Bair, Matthew J.; Matthias, Marianne S.; Department of Psychology, School of ScienceObjective Goal setting is a common element of self-management support programs; however, little is known about the nature of patients’ goals or how goals change during pain self-management. The purpose of the current study is to explore how patients’ goals and views of goal setting change over the course of a peer-led pain self-management program. Methods Veterans (n = 16) completing a 4-month peer-led pain self-management program completed semi-structured interviews at baseline and follow-up regarding their goals for their pain. Interviews were analyzed using immersion/crystallization. Results Analyses revealed six themes: motivation to do something for their pain, more goal-oriented, actually setting goals, clarity of goal importance, more specific/measurable goal criteria, and more specific/measurable strategies. Conclusion The current analyses illustrate how participants’ goals can evolve over the course of a peer-led pain self-management program. Specifically, increased motivation, more openness to using goals, greater clarity of goal importance, more specific and measurable goals and strategies, and the influence of the peer coach relationship were described by participants. Practice implications Pain self-management interventions should emphasize goal setting, and development of specific, measurable goals and plans. Trainings for providers should address the potential for the provider-patient relationship, particularly peer providers, to facilitate motivation and goal setting.